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Clinical Journal of Gastroenterology

, Volume 12, Issue 1, pp 15–19 | Cite as

A case of gastric cancer with delayed onset of tumor reduction effect by nivolumab therapy

  • Rika SatoyoshiEmail author
  • Osamu Muto
  • Akio Masuda
  • Kei Kotanagi
  • Takuya Kichiraku
  • Kazuhiro Kudoh
  • Toshiya Sawada
  • Hideaki Miyazawa
  • Hitoshi Kotanagi
Case Report
  • 175 Downloads

Abstract

Immune checkpoint inhibitors may have different clinical effects compared with conventional anticancer drugs. An 85-year-old male received chemotherapy for recurrent gastric cancer. As liver metastasis progressed, nivolumab was introduced as a fourth line treatment. Progression of liver metastasis in size was observed in CT after 3 courses of nivolumab therapy. Nivolumab treatment was discontinued, because the general condition of the patient also worsened. However, his general condition improved as hepatobiliary enzyme levels, inflammatory response, and tumor markers improved. Liver metastasis was shrinking on the image, so we resumed nivolumab therapy. To the authors’ knowledge, this is the first case of pseudoprogression undergoing immunotherapy for gastric cancer. In this case, the antitumor effect was exhibited in a delayed manner and the tumor shrinkage was obtained.

Keywords

Gastric cancer Nivolumab Pseudoprogression MSI 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Human/animal rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  • Rika Satoyoshi
    • 1
    Email author
  • Osamu Muto
    • 2
  • Akio Masuda
    • 1
  • Kei Kotanagi
    • 1
  • Takuya Kichiraku
    • 1
  • Kazuhiro Kudoh
    • 1
  • Toshiya Sawada
    • 1
  • Hideaki Miyazawa
    • 1
  • Hitoshi Kotanagi
    • 1
  1. 1.Department of Gastroenterological SurgeryAkita Red Cross HospitalAkitaJapan
  2. 2.Department of Medical OncologyAkita Red Cross HospitalAkitaJapan

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